Coronavirus Outbreak – Information for staff, physicians, learners and volunteers – FAQ

Please note: This information is not for distribution outside of Unity Health; we are using a private section of our external website to allow staff easy access to these materials offsite and after hours.

Novel coronavirus (COVID-19) frequently asked questions
Updated March 30, 2020

See the latest updates and resources on the COVID-19 outbreak information for staff, physicians, learners and volunteers.

COVID-19

COVID-19 is a newly recognized coronavirus that was recognized as causing human disease in late 2019 in Wuhan, China. Coronaviruses are a large family of viruses ranging from well known viruses that can cause the common cold, to viruses like SARS that are extremely severe. We do not yet know the full spectrum of disease of COVID-19 although it appears capable of causing both mild and severe illness.

No, seasonal coronavirus and COVID-19 are different types of coronavirus. Seasonal coronavirus is common in Canada and is one of the causes of the common cold and usually results in a mild illness. COVID-19 is a new coronavirus and much remains unknown about it. While it also causes a cold- or flu-like illness, it can also result in severe disease although we do not yet know how often this occurs. Note that when patients with a fever and respiratory illness are tested for COVID-19, they are also tested for more common viruses like influenza and regular coronavirus – so you may see test results positive for coronavirus but these are NOT the COVID-19 coronavirus.

The single most important thing you can do is to use routine practices for all clinical interactions. Routine practices include conducting a risk assessment, performing hand hygiene, disinfecting all shared equipment, and wearing all required personal protective equipment relevant to the patient’s condition and the planned clinical task.

You should also understand the Travel Risk Screening Tool (in the resource section of the COVID-19 pageand the personal protective equipment required if you are assessing or caring for a suspected or confirmed case.

Follow our travel policies outlined on the COVID-19 page. Even if you have not traveled, staying home from work if you have a febrile respiratory illness is critically important to protect your patients and colleagues. If you are unwell, please notify Occupational Health (Corporate Health at St. Michael’s) and stay home.

Finally, all staff should ensure that they:

  • are fit tested and know your N95 respirator fit, and that it is available in your area
  • are trained and confident in the correct donning and doffing of personal protective equipment (PPE) required for Airborne, Droplet and Contact precautions
There is a guidance document that has been provided by the Ministry that outlines appropriate practice – please familiarize yourself with this. You should screen patients if you can before you go into their home and, if they meet criteria for suspected cases, contact public health to determine the next steps. In some cases it may be necessary to send them to the Emergency Department or public health may be able to assess them at home.
  • Use safe practices for every clinical interaction. By using appropriate routine practices for all clinical encounters, including performing hand hygiene, disinfecting shared equipment and wearing personal protective equipment as required, we can significantly reduce the risk of COVID-19 transmission even from an unrecognized case. See our ‘Routine Practices and Additional Precautions’ policy for further information.

    AND

  • Perform admission and daily screening for acute respiratory infections (ARI) and other infectious symptoms. All patients presenting should be screened on presentation/admission and daily for new infectious symptoms, including (but not limited to) fever and respiratory symptoms.

    AND

    • Take a travel and exposure history for all patients upon presentation. Screening tools are in the resource section on the COVID-19 page.

     

To minimize the risk of infectious disease transmission, we are recommending staff, physicians and learners reduce close physical interactions where possible. Here are some guidelines.

    • There should be no in-person gatherings of 25 or more people at Unity Health
    • Smaller in-person gatherings should strive to ensure a distance of two metres between individuals
    • Smaller meetings can still pose a risk to the organization if they include an essential group
    • For some events, participants may not all present at the same time, but risks such as shared food still need to be considered

  • Ask the patient to clean their hands and provide them with a surgical mask
  • Move the patient to a private room or designated area away from other patients and staff
  • Put up a sign indicating that the patient is on Droplet and Contact precautions
  • Staff must use Droplet and Contact precautions for all routine interactions with suspected cases (i.e. surgical/procedure mask, eye protection, gown and gloves in addition to routine practices)
  • A fit-tested, seal-checked N95 respirator should be used instead of a surgical/procedure mask when performing an aerosol-generating medical procedure such as an airway intubation or CPR, for example
  • Contact Infection Prevention and Control if you require any further assistance or have questions 

Soarian admission orders are now available for admitting COVID-19 positive patients  to the general ward or to the ICU.

Our guidelines are designed to protect staff so as long as guidelines are followed, staff shouldn’t need to be quarantined. If something goes wrong with donning PPE, please reach out to Occupational Health.

A normal number of people should accompany the patient wearing appropriate PPE. There should be one extra person who is “non-contaminated” to open doors, push elevator buttons, etc.

Please let everyone on the care team know about the person under investigation (PUI) status. When contacting support partners (i.e. portering, security, environmental services, etc.), it is critical that you inform them if the patient you require support with is a PUI or has tested positive for COVID-19 so that they can ensure they have the appropriate personal protective equipment. Please also inform the diet office of these details because they will use disposable dishes and deliver food to the unit rather than directly to the patient’s room.

Effective March 20, 2020, the Ministry of Health outlined that all patient transfers between Ontario hospitals, including emergency transfers, require a Provincial Transfer Authorization Centre (PTAC) issued Medical Transfer Authorization Number before transport. This is required for all methods of patient transport including air ambulance, land ambulance and private transfer service. For Ontario hospitals looking to arrange a patient transfer, please follow the steps below:

  • Login to the online PTAC Portal
  • Complete the PTAC Screening Report. If the patient does not screen positive for COVID-19, a Medical Transfer (MT) Number will be issued immediately.
  • If the patient is flagged positive, an MT Number will not be issued automatically. The sending facility is to contact the Ornge Operations Control Centre (OCC) to process the generation of an MT Number manually.

The only exclusion to the steps outlined above is for Federal Nursing Stations that follow a different process with Ornge. For more information, please refer to the Ornge PTAC Frequently Answered Question page.

We currently have no patients being cared for at Unity Health with COVID-19. We do have plans to care for patients with COVID-19 at our sites if needed.

Patient care and associated services

All non-urgent and elective procedures and appointments

In line with our partner hospitals, we are moving to cancel all non-urgent and elective procedures and appointments including in our ambulatory areas effective Wednesday, March 18 to keep our beds ready to support anyone who comes in with COVID-19-related care needs. Our teams are currently reaching out to patients who are scheduled to come in this week to ensure they are aware of this change.

Adult Day Program at Providence Healthcare

Out of an abundance of caution to protect our clients, staff and physicians, Providence Healthcare will be temporarily suspending its Adult Day Program (ADP) effective Friday, March 20. At this time, we anticipate that the program will be suspended for four weeks, but given the rapidly evolving situation, this timeframe will be re-evaluated in the upcoming weeks. The ADP will continue its services to clients currently booked for consecutive-stay overnight visits (i.e., respite care). We will not be accepting new clients for respite as of March 17.

Masses in the St. Joseph’s Health Centre chapel

Due to COVID-19 restrictions, all masses in the St. Joseph’s Health Centre chapel were cancelled effective March 20.

Health Records – inquiries via phone, fax or email only

Effective March 23, Health Records closed its doors and will be accepting inquiries via phone, fax or email only. For requests at Providence, phone is 416-285-3666 ext. 4336, fax is 416-285-3635 and for email inquiries, please contact healthrecordsPHC@unityhealth.to.  For requests at St. Joseph’s, phone is 416-530-6047, fax is 416-530-6046 and for release of information, email ROI@stjoestoronto.caFor requests at St. Michael’s, phone is 416-864-6060 (ext. 2169), fax is 416-864-5831, for general health records inquires, email healthrecords@smh.ca, and for release of information, email ROI@smh.ca.

Residential withdrawal management services at St. Joseph’s and St. Michael’s

In light of the evolving COVID-19 situation, we have made the difficult decision to temporarily close our residential withdrawal management services at St. Joseph’s (Glendale House) and St. Michael’s effective Monday, March 23. We know these services provide important support to members of our communities, which is why we are reaching out to make sure clients are aware they can access support through our Addiction Medicine Services at both sites that will continue to provide virtual video, telephone and walk-in options. You can find out more about these resources by calling St. Joseph’s at 416-530-6486 ext. 3969 or St. Michael’s at 416-864-3082.

Additional resources available in our communities include:

  • Residential Withdrawal Management Bed Availability (24/7): 1-866-366-9513
  • Telephone support from Coordinated Access to Addiction Services (Monday to Friday from 9 a.m. to 4:30 p.m.): 1-855-505-5045
  • Shelter Central Intake (24/7): 416-338-4766
  • Additional Resources/Supports (24/7): 211

Health Sciences Library

The Health Sciences Library spaces at Unity Health Toronto are closed until further notice. Library services such as literature searches, research/information inquiries, and inter-library loan requests (articles only) will continue to be available remotely for all Unity Health Staff and physicians from Monday to Friday, 8 a.m. to 6 p.m. All online Library resources are still available 24/7. Due dates for borrowed materials will be suspended indefinitely.

Please find contact information for each site below:

St. Joseph’s:

St. Michael’s:

Providence:

Staff amenities

In light of the evolving COVID-19 situation, the decision has been made to temporarily close the Sunlife Financial Lakeside Wellness Centre at St. Joseph’s and the George Macri at Providence to help protect our people, patients and communities. There will be updates provided as to when you can expect to be able to come back into the gym.

TEsting

We – along with several other Ontario hospitals – are working with Public Health Ontario to expand our surveillance approach to ensure we have a system capable of identifying community transmission as early as possible. As part of this surveillance, a subset of patients that have nasopharyngeal swabs sent to the laboratory for influenza and other viral testing will also automatically have their specimens forwarded to the public health laboratory for COVID-19 testing.

This has been implemented in our Emergency Departments at both St. Joseph’s and St. Michael’s for admitted patients. This means you may see COVID-19 test results on patients who did not have that test ordered by the ordering physician.

Laboratory Medicine has created a unique test code for COVID-19 testing which will remain lab orderable only to ensure the mandatory PHOL paper requisition is completed and accompanies the specimen to the lab. A COVID-19 PCR test result will be more easily identified in Soarian and Sunrise as it will be listed as an independent test result and will indicate if the specimen was tested for diagnosis “COVID-19 Investigational” or for surveillance “COVID-19 Surveillance.”

These patients will only require flu precautions unless there is an unexpected positive test, in which case appropriate urgent action will be taken. Currently, we expect to receive results within 24-48 hours, but this may increase as demands increase.

  • Suspect case = someone who meets the screening criteria 
  • Probable case = someone who meets the screening criteria and laboratory diagnosis of COVID-19 is not available, inconclusive or negative (if specimen quality or timing is suspect)
  • Presumptive case = someone tests positive at the Ontario Public Health lab
  • Confirmed case = someone tests positive at the national lab

Testing should only proceed after the patient meets screening criteria and/or is reviewed by Infection Prevention and Control and microbiology. Specimens must be:

  • clearly labeled as suspect COVID-19
  • hand delivered to microbiology. DO NOT place any specimens into the pneumatic tube system
  • accompanied by a completed COVID-19 Public Health Ontario requisition form

The following specimens may be tested for COVID-19 in patients under investigation:

  • Inpatients: Nasopharyngeal (NP) swab  in Universal Transport Media
  • Outpatients: Nasopharyngeal (NP) swab in Universal Transport Media
    AND throat swab in Universal Transport Media

Other specimens collected from patients under investigation (including bloodwork) must be:

  • clearly labeled as suspect COVID-19
  • hand delivered to microbiology. DO NOT place any specimens into the pneumatic tube system

Testing for other respiratory viruses and community-acquired pneumonia: Admitted patients with suspect COVID-19 presenting with signs of pneumonia should be tested for bacterial or other causes as applicable. Suggested tests may include:

  • PCR for influenza and other respiratory viruses – this can be ordered on the same NP swab submitted for COVID-19
  • Blood Cultures
  • Mycoplasma pneumoniae/Chlamydophila pneumoniae PCR – this can be ordered on the same NP or throat swab submitted for COVID-109 testing
  • Legionella PCR can be ordered on the same lower respiratory tract specimens submitted for COVID-19 testing (e.g. BAL, pleural fluid, lung tissues)
  • Legionella urinary antigen testing: submit a urine specimen in a sterile container

For patients at St. Joseph’s:

If you are caring for a patient at St. Joseph’s who has been tested for COVID-19, you will now be able to access their results – once available – through SOVERA, under ‘COVID19 ASSESSMENT.’

For patients at St. Michael’s:

If you are caring for a patient at St. Michael’s who has been tested for COVID-19, you will now be able to access their results – once available – one of two ways:

  • Through SOVERA, following this path: SOVERA  > ECHART  >  COVID19 ASSESSMENT
  • Through Soarian, following this path: Soarian  >  Scanned documents  >  Other documents  >  COVID19 ASSESSMENT

If you have any questions about this process, please reach out to Helpdesk or Health Records at your site.

In people who have been exposed but are asymptomatic, the test will be negative until shortly before the onset of symptoms.  So if you are swabbed two days after an exposure, and the result is negative, this does not mean you will not get COVID-19 on day eight.  Despite what people hear in the media, testing asymptomatic health care workers is close to useless.  On the other hand, for a symptomatic health care worker, testing should be prioritized and, if negative, would suggest the illness is not COVID-19.

Unity Health Toronto staff who were tested for COVID-19 at the St. Joseph’s or St. Michael’s Assessment Centres on or after March 21st will now be able to register remotely for MyChart and access their test results – once available – through the platform. To register for MyChart remotely, please call Health Records at your respective sites (numbers below).

  • If you were tested at St. Joseph’s COVID-19 Assessment Centre, please call 416-530-6000 ext. 6047
  • If you were tested at St. Michael’s COVID-19 Assessment Centre, please call 416-360-4000 ext. 2169

Please note you will be asked to provide your full name, health card number, and you will be asked to answer a series of security questions to verify your identity. The option to view COVID-19 test results from Unity Health’s Assessment Centres in MyChart is currently only available for staff at Unity Health who received testing on or after March 21, 2020. Also note that in MyChart all COVID-19 test results will be labelled ‘COVID-19 Virus Detection’ – this does not mean the test result is positive. Please read the full result to understand whether the virus is detected or undetected in your test results.

Screening and entrances

  • Effective Saturday, March 21 at 9 p.m., we are no longer permitting family/support persons (visitors) at any of our sites, including our Reactivation Care Centre.
  • Resources are available for you to use under the “Family presence (visitor) restrictions” section in the resources box below

  • We will make every effort to ensure that the needs of patients and families are met while this temporary restriction is in effect.

  • This includes looking into technology-enabled solutions; our teams are looking at how to support virtual visits and we will share more details about this as they become available.

  • In the meantime, patients at St. Michael’s and Providence are able to use their bedside phones, free of charge and patients at all sites can use their own devices to access the guest WiFi

  • There will be limited exceptions to this policy including:

    • End of life patients (including palliative, critical care and Emergency Department)

    • Patients under the age of 16 – limited to one designated parent or guardian

    • Women giving birth – limited to one partner or coach

    • Patients who lack capacity to consent to treatment and for whom other means of communication with their substitute decision maker have failed

    • Patients who require support to access critical ambulatory services (i.e. day oncology, dialysis, medical imaging)

We will continue to screen visitors at the door. If any visitors fail the screening, they will not be allowed entry even if they fall under the list of exceptions.

Please only use the designated staff screening entrances for both entering and exiting the building.

 

  • St. Joseph’s staff, physicians and learners: The Sunnyside parking garage bridge entrance is closed. If you are parking in the Sunnyside garage, you will need to enter and exit through the Melnyk entrance.
  • At St. Michael’s: EXCEPTION: Staff and physicians entering St. Michael’s Hospital who have accessibility needs can use the Queen Street entrance at any time of the day.
  • Providence staff, physicians and learners: Providence badges do not have a barcode, which is required for scanning. Providence staff, physicians and learners will be provided with an additional barcoded badge upon arrival to the main entrance of the hospital. You will be required to keep both your photo ID badge and your barcode badge with you at all times.

Badge scanning
Please ensure you have your photo ID badge with you at all times. Your badge will be required for scanning as part of the screening process. If you forget your badge, you will be required to fill out paper documentation.

Staff, physician and learner self-screening
You will be asked to attest and screen yourself upon entering the building. By scanning your badge you are confirming that you are feeling well, are able to work and you do NOT have any of the following:

  • fever or
  • new or worsening cough or
  • new sore throat or
  • new runny nose or
  • new shortness of breath or
  • close contact with someone who has tested positive for COVID-19 in the last 14 days

If you answered YES to any of the criteria listed above:

  1. Do not enter the building
  2. Contact your department and notify them of your absence
  3. Contact Occupational Health to obtain clearance to return to work:
    • Joseph’s: 416-530-6800
    • Michael’s Corporate Health: 416-864-5400
    • Providence: 416-285-3666, ext. 4386 

At this time we will not be doing temperature screening at our entrances. Current evidence suggests that symptomatic individuals may not have a fever. For this reason, we are focusing on the symptoms listed above.

Unity Health has initiated patient screening in the ED and all ambulatory areas. All patients coming to triage or registration are asked about symptoms of COVID-19 and travel outside of the country within the last 14 days. Those with symptoms and travel are promptly isolated and managed in precautions and in consultation with infection prevention and control.

Toronto Public Health is following up with anyone who has a positive test result. We are not giving out test results in our ED. You can direct patients with questions to call Toronto Public Health’s Hotline at 416-338-7600, Monday to Friday from 8:30 a.m. to 4:30 p.m. after hours, people can call 311 and ask for Toronto Public Health.

It’s fair for your team to tell people that we don’t have all of the answers – Toronto Public Health is the source of truth and, given how quickly the situation continues to evolve, it is entirely fair for you to direct people there for the most up to date information and if they have any questions.

Just please take a moment to recognize their concerns and reassure them Toronto Public Health is the right contact for them to call.

There are barriers between patients and staff in both of our Emergency Departments. At St. Michael’s, the first barrier is a staff member in full personal protective equipment (PPE) and then triage and registration are behind Plexiglas. At St. Joseph’s, patients and visitors are directed to the welcome desk which is fully screened in behind a glass partition. If a patient requires additional screening, staff will go into full PPE to escort the patient into an appropriate location.

Screening at clinical satellite locations

We have implemented entrance screening at the following locations:

  • 61 Queen St. East
  • Lawrence Health Centre
  • 80 Bond St.
  • Health Centre at 410 Sherbourne
  • James Town
  • Sumac Creek
  • Community Renal Centre on Islington

Passive screening at office satellite locations

All staff are reminded that they should NOT be coming to work if they are unwell or have come in contact with a COVID-19 case. You must also speak with your manager before coming into work if you have travelled outside of Canada in the last 14 days. There are posters up to remind staff of these details. For questions on screening practices at office satellite locations, please contact the property’s management. Some locations are now only accessible via access cards that are provided to tenants, so you may have to arrange access with colleagues in the building before visiting.

Assessment centres

In partnership with Public Health, we opened two COVID-19 Assessment Centres to provide comprehensive screening, assessment and testing. You will only be tested for COVID-19 if you:

  • Have mild symptoms (e.g. cough, sore throat, runny nose)

AND, you:

  • Work in an at risk-setting (hospital, long-term care home, etc.)
  • Live in a vulnerable setting (homeless shelter, retirement home)
  • Have been referred directly by Toronto Public Health

Those who are determined to require self-isolation will also be provided instructions and support materials. 

In both centres, we are taking all precautions to ensure the safety of our people and those visiting the centres. 

The assessment centre at St. Joseph’s is located on the first floor of the Sunnyside building.

  • Staff and patients who use this building and entrance will continue to do so for outpatient appointments.
  • Proper precautions, such as hand hygiene stations and isolated spaces for those who are being assessed for COVID-19, have been put in place to ensure the safety of those who are not accessing the assessment centre.
  • Access to the gym is available through the basement.

The assessment centre at St. Michael’s is located in the Li Ka Shing Knowledge Institute, in and right outside room 136.

  • Staff, learners and researchers will continue to use the building.
  • The Shuter entrance will be used only by those accessing the COVID-19 Assessment Centre.
  • The space is closed off from the rest of the building with doors and semi-permanent walls to ensure the safety of those in the building who are not accessing the centre.
  • Access to the Simulation Centre in the basement is limited.
  • The elevators on the east side of the building will not stop on the first floor or the basement from the upper levels.
  • St. Joseph’s: 9 a.m. to 9 p.m.
  • St. Michael’s: 9 a.m. to 7 p.m.

These hours may change based on volumes and need.

Our assessment centres will screen all ages that fall under the guidelines. For example, if a child presents to the assessment centre with mild symptoms of COVID-19 and they live in a vulnerable setting, they will be tested at the assessment centre. However, we may recommend that anyone six months and younger with respiratory symptoms go to the Emergency Department.

Once patients are screened and assessed, any who test positive will receive directives from clinicians and will be cared for appropriately.

In alignment with new Toronto Region COVID-19 Hospital Operations group guidelines, COVID-19 Assessment Centres will now focus on symptoms, and testing in the assessment centres will be limited to those who have mild symptoms and are at risk of transmitting COVID-19 to large groups of people, including:

  • Those who work in at-risk settings (i.e. hospitals, long-term care)
  • Those who reside in vulnerable settings (i.e. homeless, prison, retirement home)
  • Those who have been sent by Toronto Public Health (i.e. from areas with active cluster outbreaks)

Everyone else, including those with mild symptoms who have returned from travel, does not need testing unless they get sick enough to go to the Emergency Department.

Our aim, with this approach of testing, is to have a more measured, targeted use of existing resources and to limit exposure in testing centres to those who are medically frail or immunocompromised. 

 

Those who arrive at our assessment centres but do not match the guidelines from the Toronto Region COVID-19 Hospital Operations group (i.e. they do not work in at-risk settings, live in vulnerable settings or have been referred by Toronto Public Health) will be asked to either return home and self-isolate or go to the Emergency Department if their symptoms are severe.

Everyone who has symptoms of COVID-19 and fits the guidelines from the Toronto Region COVID-19 Hospital Operations group (i.e. work in at-risk settings, live in vulnerable settings or have been referred by Toronto Public Health) can be screened in our assessment centres at no cost.

ReDeployed staff

Your safety is our highest priority. This is particularly the case when an employee is assuming a vital function in a new part of the organization as a result of redeployment. Our approach to supporting you to work safely when you are being redeployed includes the following:

  • Onboarding communication telling you about your new role
  • Meeting and onboarding with the manager of the area you are being redeployed to
  • Safety training (i.e. proper use of personal protective equipment (PPE)) if necessary in the role you assume

You will receive your redeployment assignment either from your immediate manager or a member of the Staff Redeployment Centre.  Following that initial contact, you will receive an email with all of the details you will need about you redeployment assignment as well as a contact person who will answer any questions you have about the specific role and work area.  

Redeployment assignments will be continuously monitored. In some cases, it may be that your “home” department requires your return. In those cases, we will work with your manager to return you to your home position as quickly as possible and in a manner that prioritizes patient care.  

Unity Health Toronto will endeavor to redeploy staff in as fair and equitable manner as possible given the constraints that exist on time and staff resources.  We will give priority to redeploying staff whose work has temporarily stopped or slowed due to program/clinic reductions and closures.  In all cases where there are limited numbers of people required to be redeployed from a group of employees, we will do our best – given time and other pressures – to determine if there are volunteers for reassignment first. 

There is no way to perfectly predict the duration of the health human resources challenges that are emerging. If you are being redeployed to an assignment that is likely to be of a continuing nature, we will be transparent with you and let you know that. All assignments will be evaluated on a week-by-week basis so that we can ensure our people resources are deployed in a way that best meets our patients’ needs. 

All staff who are redeployed will be paid their current hourly rate. Staff who are unionized will continue to accumulate service and seniority in the same manner as outlined in their collective agreement. Overtime rates and premiums will be paid in a manner consistent with the collective agreement or organization policy, depending on which applies.  

providence

Yes, the screening procedures at Providence follow the exact same process.

Yes, direction from the Ministry of Long-Term Care has restricted visiting access. Non-essential visitors and private caregivers will not be allowed to enter. Essential visitors would include those in cases where residents are very ill or requiring end-of-life care.

Masks and other personal protective equipment (PPE)

On the week of March 23, we shared details of our new process that requires all staff and physicians working in patient care areas to wear a mask at all times outside of breaks. We have created a new resource page on our website that outlines everything you need to know about this move, including frequently asked questions. Should you have any additional questions about our new universal masking process, please speak with your manager.

The Ministry of Health has shared a new directive on caring for patients with suspected COVID-19 to droplet contact precautions after finding no evidence for COVID-19 transmission through the airborne route. Here’s what you need to know:

  • Effective immediately, Unity Health will use droplet contact precautions for caring for patients with suspected COVID-19 which includes the use of surgical/procedure mask, eye protection, full sleeved gown and gloves.
  • An N95 respirator should only be used when performing an aerosol-generating medical procedure such as an airway intubation or CPR, for example.

Putting on and taking off PPE properly is as important as selecting the correct PPE. Infection Prevention and Control will be offering in-person refreshers on how to safely don and doff the personal protective equipment required to assess and care for patients with suspected COVID-19 infection – watch for announcements about the timing of these sessions at all sites. Here’s a video outlining the process as well.

We are not giving out masks for personal use. Our personal protective equipment is intended to protect all staff while at work and we need to ensure that we have sufficient supplies at all times in order to assure staff and patient safety.

Masks should be used as part of routine practices by staff and physicians in clinical areas.

All ambulatory areas are being treated in the same way – they are receiving instructions and training on personal protective equipment. 

We have a pandemic supply of personal protective equipment that we are distributing across our sites and we are working with suppliers to ensure we have an ample supply to replenish our stocks as needed. We are prioritizing areas based on need.

Everyone who works in clinical areas and who may need to wear an N95 mask as part of their work should have up-to-date mask fit testing. 

Please check your fit testing card for the make and model and the date in which you were tested. Fit testing is valid for a period of two years. If you need to get retested, please visit the Occupational Health and Safety office at your site.

Providence
Location: OHSW, D207
Monday and Tuesday, 8 a.m. to 4 p.m.
Wednesday, 6:30 a.m. to 4 p.m.


St. Joseph’s
Location: OHS, Sunnyside room 204
Monday to Friday, 7:30 a.m. to 3 p.m.

St. Michael’s
Location: CHSS, 2-037 Shuter

Monday to Friday, 7 a.m. to 3 p.m.

Our supplies are for use by our clinical teams. If someone is asking for a mask for their personal use outside of the hospital, they should be encouraged to visit their local hardware store or pharmacy for purchase. 

No – our Gift Shops will not be selling masks (N95 or patient/surgical masks).

Cleaning

Environmental Services staff will be notified anytime a suspected case is assessed and the area will be cleaned and disinfected immediately afterwards. Our routinely used cleaning and disinfection procedures will remove and inactivate coronavirus. Environmental services staff will be using the same personal protective equipment as all other staff that enter the room of a patient with suspected coronavirus.

On a daily basis, our Environmental Services teams are reviewing hospital activity, cleaning needs and planning staffing to ensure we have enough support for enhanced cleaning measures. The teams have priority cleaning tasks for both clinical spaces and public spaces to ensure all critical cleaning is provided uninterrupted. Currently there are 28 additional cleaning assignments across the sites that are reviewed and planned for daily, which includes additional cleaning staff in public spaces at all sites.  

If you have a concern or would like to make a cleaning request, please connect with Environmental Services at your site.

Contact your site’s Environmental Services team to let them know where the hand sanitizer is that needs refilling.

You can request one using the Environmental Services request form at your site.

Emergency Department

We are asking everyone to limit movement through the Emergency Department if possible to allow more space for patients. We have asked all areas transferring to the Emergency Department from an ambulatory clinic, code blue or other medical emergency to call ahead to the team leader so they can be prepared for screening.

Waterproof gowns are available for specific procedures as part of routine practices in Emergency Departments and other areas where they may be needed if exposure to large amounts of fluid are possible. They are not something we are routinely recommending for patients suspected for 2019-nCoV but can be used in specific circumstances.

Occupational Health

Occupational Health can be reached at your site:

  • St. Joseph’s: 416-530-6800
  • St. Michael’s Corporate Health: 416-864-5400
  • Providence: 416-285-3666, ext. 4386

No one should be coming to work when feeling unwell. Regardless of travel, if you have symptoms consistent with COVID-19, do not come to work, notify you department/manager of your absence and contact Occupational Health. Symptoms include:

  • new or worsening cough or
  • new sore throat or
  • new runny nose or
  • new shortness of breath or
  • close contact with someone who has tested positive for COVID-19 in the last 14 days

In the event symptoms develop while you at work, stop working, perform hand hygiene, put on a procedure mask, notify your department/manager and contact Occupational Health:  

  • Joseph’s: 416-530-6800
  • Michael’s Corporate Health: 416-864-5400
  • Providence: 416-285-3666, ext. 4386

We are working on a work from home policy right now that we will share as soon as we are able to.

We want to protect all staff regardless of whether or not they’re immuno-compromised, as we don’t want anyone to get COVID-19. Even if you’re not immuno-compromised, you work with immuno-compromised patients. We have the right systems, training and PPE procedures in place but if you are concerned, you can connect with Occupational Health, who can advise on a case-by-case basis.

At this point, we are not limiting staff travel between sites though that could change if there is an outbreak or significant spread.

Given the rapidly evolving spread of COVID-19 in many parts of the world, we have updated our travel policies for all staff, physicians, learners and volunteers, including the process for being cleared to come back to work. These are in line with all of our partner Toronto hospitals and are in place out of an abundance of caution to help protect you and those around you.

Work-related travel
All travel outside of Canada for hospital-related purposes must be cancelled or postponed indefinitely. In addition, all international travel to Canada for work-related purposes, including delegations, meetings, conferences or external student/observer placements, should be cancelled until further notice.

Personal travel
All travel outside of Canada by staff, physicians, learners and volunteers needs to be reported to Occupational Health (Corporate Health at St. Michael’s) BEFORE you come back to work. A quick phone call will ensure Occupational Health is aware of your situation and can clear you to return to work. Occupational Health can be reached at their hotline: 416-864-5415.

To countries with active government travel advisories: Anyone considering travel should always check on government travel advisories. Vacation travel to areas where the government has recommended avoiding non-essential travel is strongly discouraged, but if you do go on vacation in these countries, you must:

  • Report that travel to your manager and Occupational Health and Safety before you go.
  • Understand that you will not be able to come back to work for 14 days after your return home.
  • You will not be paid during this required quarantine period.

To countries not currently covered by a travel advisory:

  • You may be quarantined while on vacation or be quarantined upon return if the country you travel to is added to the list with travel advisories while you are there.
  • In countries with limited health care services, you may not be able to access what you need in the event that you become ill. This applies to all illnesses – not just COVID-19.
  • Upon return from your vacation, you may be quarantined at home if that country has reported cases of COVID-19 or you have travelled on an aircraft or other vessel with reported cases of COVID-19.

Travel precautions
In any travel that you are doing, ensure you are following regular health precautions including:

  • washing your hands often using an alcohol-based hand sanitizer or soap and water
  • avoiding touching your eyes, nose and mouth with unwashed hands
  • avoiding contact with people who are sick
  • covering your cough with a tissue or sneeze in your elbow
  • frequently cleaning and disinfecting touched objects and surfaces

Should you have any questions at all, please connect with your manager or contact Occupational Health (Corporate Health at St. Michael’s). 

On March 19, 2020 the Chief Medical Officer of Health issued new guidance: “Managing Health Worker Illness and Return to Work COVID-19” that says health care workers should self-isolate for 14 days after travel unless they are deemed critical to continued operations. Unity Health Toronto will be putting these changes into effect as of 7 a.m. of Friday, March 20.

Here’s what that means for you

For anyone who has returned from international travel on or after March 5, you should connect with your leader (Manager or Department Chief) to determine if you can self-isolate at home. That decision will be made using the following guidelines:

  • Can you do your job from home?
  • Is your on-site availability critical to the operation of your department and/or the organization?

If you are a staff member or physician and able to work from home: you should follow Public Health’s self-isolation guidelines (see links below) for 14 days after your return date. If, over the course of your isolation, you are needed to provide essential services on site and you are asymptomatic, your Manager or Chief will call you and you will be required to return to work while taking the appropriate precautions.

If you are a physician and you are able, with input from your Chief, to cancel non-urgent care or provide virtual care, and obtain coverage for inpatient, essential ambulatory or call responsibilities: you should follow Public Health’s self-isolation guidelines for 14 days after your return date. If, over the course of your isolation, you are needed to provide essential services on site and you are asymptomatic, your Chief will call you and you will be required to return to work while taking the appropriate precautions.

If your job is critical to providing patient care and you cannot work from home: you should come to work and do the following:

  • undergo regular screening
  • use appropriate PPE (surgical mask) at all times for the 14 days from your return date
  • undertake active self-monitoring including taking your temperature twice daily to monitor for fever
  • immediately self-isolate if symptoms develop (fever, new cough, difficulty breathing) and contact their manager and Occupational Health.

If your job is not immediately critical to providing patient care and you cannot work from home: you will be asked to self- isolate at home, and may be required to return to work while taking the appropriate precautions should circumstances change.

If at any point you feel unwell at work: you must immediately self-isolate and contact your manager and Occupational Health.

Returning to work

At the end of the 14 day period, normal terms of work apply for asymptomatic employees. If you fail the screening tool or are symptomatic, you must call Occupational Health:

    • St. Joseph’s: 416-530-6800
    • St. Michael’s Corporate Health: 416-864-5400
    • Providence: 416-285-3666, ext. 4386

Scenario: I am planning to come in for my next shift and I have travelled in the last 14 days outside of Canada. What should I do?

  • Contact you manager
  • Contact Occupational Health and provide them the date you returned to Canada. You may be asked to provide proof of travel 
  • Discuss with your manager if your role is critical to the continued operations and patient care of your department/service.
  • Refer to ‘Here’s what that means for you’ section above for next steps.

What does self-isolate mean?

If you have recently travelled outside of Canada and have been advised to self-isolate, you should follow these guidelines:

What PPE should we be using and why?

If your job is critical to providing patient care and you must be at work within the 14 day period after returning from travel outside of Canada, you should wear a procedure/surgical mask when around others. 

If you travel to a country with an active government travel advisory, you will not be paid during your quarantine upon return.

However, you will be paid if the isolation comes at the event of travelling somewhere without an advisory or if the advisory is put in place after you have departed.

We are working on a policy decision around this and will update as soon as we are able to.

The week of March 16, we rolled out several policies to continue supporting our patients and our people while minimizing in-person interactions. One of those policies included new work-from-home guidelines that were shared with leaders across the network on March 18. The guidelines asked leaders to enable some employees to work from home, where appropriate. If you have any questions about this, please connect with your manager.

We are absolutely still hiring new staff especially as we are looking to fill some immediate staffing needs with our screening and assessment centres. And we are looking at doing virtual interviews.

Yes! We have an urgent need for staff from across the organization to support our preparation and response efforts to the COVID-19 situation. If you are a clinical or administrative employee who would like to support the organization’s efforts in this regard, please fill out this availability form (download) and share the completed version with your manager who will share it with Human Resources. Managers have been asked to identify staff for potential redeployment as early as end of day today so please act quickly on this if you are interested. Our staffing needs cover a wide variety of areas, but include the following:

  • Emergency Departments
  • Assessment Centres
  • Patient information and support
  • Entrance screening

Should you have any questions, please contact rcstaffsmh@unityhealth.to

Unity Health Toronto operates in one of the most diverse cities in the world. Our patient and our employee populations reflect this diversity and includes large numbers of people of Chinese descent. Our approach to screening and instituting precautions to protect our staff and patients is based on infection prevention and control best practices and conforms to the standards set by the Ministry of Health and Toronto Public Health. We are taking great care to ensure that these precautions continue to adhere to these high standards and reflect respect for all of our patients and visitors. At the same time we recognize that in some pockets of our society, Chinese individuals may be being subject to bias and racism borne out of fear or ignorance about the origins and nature of the coronavirus (2019-nCoV). Our values of human dignity and inclusivity not only mean that this sort of treatment is not acceptable at Unity Health, but also that we all have a role to play to actively support our patients and staff who may feel excluded or disadvantaged as a result of differential treatment of members of the Chinese community. To support this expectation, we will ensure that this forms a part of our internal communication about 2019-nCoV going forward.

We recognize the developments related to COVID-19 may cause some anxiety for our people. Please remember that the risk remains low, and be assured we are taking all steps to ensure staff safety. Staff, including physicians, experiencing significant anxiety should free to contact our Employee and Family Assistance Program (EFAP) line: guidanceresources.com or 1-866-606-6367.

Additionally, you can access these COVID-19 Guidance Resources: https://pages.e2ma.net/pages/1807892/20932

research

A few research teams at St Michael’s Hospital are engaged in setting up urgent, funded clinical trials related to COVID-19. If you are an existing research staff member who is interested in becoming involved in this work in any capacity, please contact vpri@smh.ca for next steps.

Note that if your skills and interests match the needs of a study, the research team will first speak with you and then with your manager about the feasibility of your involvement.

Yes, the Office of the Vice-President of Research and Innovation has compiled a list of funding opportunities specific to COVID-19 related research.

As the COVID-19 outbreak continues to evolve, we have made updates to services and procedures offered by our different departments in Research. This document provides a comprehensive overview of how each service has changed.

Yes, all non-essential on-site research is paused at this time. During the week of March 16, Research leaders worked with each principal investigator to determine which of their projects were essential, which could continue off-site, and which were non-essential. By the end of that week, all non-essential research was suspended.

A full guide to essential and non-essential research can be found here.

Graduate students may continue with non-essential but permissible research activities so long as the research does not involve clinical contact with patients, the students feel comfortable doing so and their graduate department Chair or Coordinator has approved their work. Please see the definition for non-essential but permissible research activities for more information. Access to research labs and core facilities is impacted. Supervisors should contact Tom Schweizer, Interim Director of the Keenan Research Centre for Biomedical Science regarding access (Tom.Schweizer@unityhealth.to).

For students who are currently receiving a stipend from the hospital, supervisors are expected to continue to pay these stipends at least through the period ending April 6, 2020.

Investigators are expected to continue the pay all research staff in accordance with their position (full-time or part-time) at least through the period ending April 6, 2020, regardless of whether or not they continue performing essential research. This situation is evolving and we will be monitoring changes to federal and/or provincial legislation with respect to employment standards that may impact this decision.

If you are interested in supporting this effort, please complete the linked form and email it to rcstaffsmh@unityhealth.to. Please copy your manager and Karen Ung (Karen.Ung@unityhealth.to) on this email. Someone from the Redeployment Centre will contact you.

Please note this is paid work. You will be paid at your current hourly rate and the funds will come from a hospital account set up for all COVID hospital supported activities (not from a research account).

Graduate students will not be redeployed to the hospital’s response to the COVID-19 outbreak.

Out of an abundance of caution and in order to help keep you and our patients safe, we have suspended all on-site research volunteer/visitor activity. This means research volunteers/visitors should not be on site at any of our hospital locations/clinics including any research locations (LKSKI, 250 Yonge, 193 Yonge Street etc.). If research volunteers/visitors are willing and able to complete their work remotely, then this is an option.

Access to the Li Ka Shing building is only available via the bridge from the hospital. Staff are asked to use the Bond St. entrance of the main hospital from 6:30 a.m. to 8 p.m. or the Queen St. entrance of the main hospital from 8 p.m. to 6:30 p.m., go up to the third floor and use badge access to cross the bridge to Li Ka Shing. For more information about this, please visit the screening section of this page.

More questions

This method of communication is available for the next time we need it and we will consider it in providing updates on an ongoing basis moving forward. In the meantime, you can find the latest information related to COVID-19 on our resource page.

To support staff who require parking downtown by St. Michael’s, we are introducing new parking options.

  • The parking garage at Li Ka Shing at 209 Victoria Street is now restricted to staff and patients only (this is on a first come first serve basis, with a limited number of spots). You will be required to show your hospital ID to enter the garage and the parking rate has been reduced to $10.
  • The Eaton Centre has generously donated 150 free daily parking vouchers which are available on a first come first service basis and can be picked up from the Li Ka Shing parking attendant when you show your hospital ID. You must use this voucher when you exit the parking garage at the end of your shift. There are 100 spots available at the Yonge Street entrance (on the fourth floor) and 50 at the Dundas/Bay Street entrance.
  • When these two parking options have exceeded their capacity, staff may choose to park at other surrounding parking lots. Consider using surrounding lots located on Bond (Church) and Queen Streets (Green P).
  • Street parking may also be available – Toronto Police Services have made changes to on-street parking enforcement to allow for more parking flexibility.

Staff reimbursement – Effective Tuesday, March 24 to April 10, any staff that have utilized paid parking around St. Michael’s will be eligible to be reimbursed for part of their costs. Staff will be eligible to be reimbursed for up to $20/day after they pay the first $10. For example: if you pay $30 for parking, you will pay $10 and can be reimbursed for $20. If you pay $15, you will pay $10 and can be reimbursed for $5.

Submit your expense information electronically to accountspayable@unityhealth.to. Please continue to use the regular expense form along with scanned images of your receipts (phone images are okay). There is no need to send in originals, but please keep these for a minimum of three months. Please submit the receipts on a bi-weekly basis to coincide with pay periods. Deadline for submission is April 8 and April 22 for payment on the next pay period.

We are monitoring the parking situation at St. Joseph’s, Providence and our offsite locations and will have an update in the near future.

Effective immediately, due to COVID-19, all Unity Health Toronto employees are required to submit expense reimbursement electronically to accountspayable@unityhealth.to  for St. Michael’s Hospital and Providence Healthcare, or to acctspayable@stjoestoronto.ca for St. Joseph’s Health Centre. This will enable us to ensure payment and keep our staff safe.

For expense reimbursements funded from a Research or Trust activity at St. Michael’s Hospital, please send those requests to researchfinance@smh.ca for review. Research Finance will then forward approved expense reimbursements to Accounts Payable. Please visit the following website for policy and process on this submission, http://stmichaelshospitalresearch.ca/staff-services/research-finance-2/

Please continue to use the expense form that is found on the Unity Health Toronto portal along with scanned images of your receipts; mobile phone images are fine. There is no need to send original receipts, but please keep them for a minimum of 3 months.

If you have any questions regarding your submission for St. Michael’s Hospital and or Providence Healthcare, please email accountspayable@unityhealth.toFor urgent matters please call 416-864-6009.

If you have any questions regarding your submission for St. Joseph’s Health Centre, please email acctspayable@stjoestoronto.ca. For urgent matters please call 416-530-6582.


  • Starting March 19, paper purchase requisitions for St. Michael’s Hospital have to be submitted for processing via e-mail.
  • St. Michael’s paper purchase requisitions and associated documents should be scanned in full and submitted to PurchaseRequisitions@smh.ca.
  • There are no changes to the e-requisition process for purchases at St. Michael’s.
  • There are currently no changes to any purchase requisition processes at Providence Healthcare and St. Joseph’s Health Centre.
For questions related to:Contact:
Infection Prevention and Control (IPAC)

Your site’s IPAC department directly:

Occupational/Corporate Health and Safety Services 

Your site’s team:

  • St. Joseph’s: 416-530-6800
  • St. Michael’s: 416-864-5400
  • Providence: 416-285-3755
Support

The Employee and Family Assistance Program:

Anything elseThe Coronavirus Management Team at questions@unityhealth.to

For more information, visit www.ontario.ca/coronaviruso or the Public Health Agency of Canada’s website.